<!DOCTYPE html>
<html style="font-size: 40px;">
<head>
	<title>医院挂号</title>
	<meta http-equiv="Content-Type" content="text/html; charset=UTF-8">
	<meta content="width=device-width,initial-scale=1.0,maximum-scale=1.0,user-scalable=no" name="viewport">
	<meta content="yes" name="apple-mobile-web-app-capable">
	<meta content="black" name="apple-mobile-web-app-status-bar-style">
	<meta content="telephone=no" name="format-detection">
	<meta http-equiv="Cache-Control" content="no-transform">
	<link rel="stylesheet" type="text/css" href="/templets/phoneBreast/css/swiper.min.css">
	<link rel="stylesheet" type="text/css" href="/templets/phoneBreast/css/online.css">
	<link rel="stylesheet" type="text/css" href="/templets/phoneBreast/css/common.css">
	<script type="text/javascript" src="/templets/phoneBreast/js/jquery1.42.min.js"></script>
	<script src="/templets/phoneBreast/js/swiper.min.js"></script>
	<script src="/templets/phoneBreast/js/js.js"></script>
	<script type="text/javascript" src="/templets/phoneBreast/js/online.js"></script>
</head>
<body>
	<div class="yygh">
		<div class="logo">
			<img src="/templets/phoneBreast/images/55.png"></div>
		<div class="clear"></div>
		<div class="xyygh">
			<h2>免费预约·无需排队·优先就诊</h2>
			<form id="myform" method="post" action="http://mail.jszjrzk.com/breast/online" accept-charset="utf-8">
				<div class="ghxm">
					<li>
						姓
						名：
					</li>
					<input type="text" id="name" name="name"></div>
				<div class="ghdh">
					<li>
						电
						话：
					</li>
					<input type="text" id="phone" name="phone"></div>
				<div class="ghbz" style="display:none;">
					<li>预约专家：</li>
					<select class="zj_sel" name="doctor">
						<option value="赵为国">赵为国</option>
						<option value="戴晓江">戴晓江</option>
					</select>
				</div>
				<div class="ghbz">
					<li>预约病种：</li>
					<select name="entity" id="entity">
						<option value="甲状腺乳腺">甲状腺乳腺</option>
						<option value="肥胖症">肥胖症</option>
						<option value="糖尿病">糖尿病</option>
					</select>
				</div>
				<div class="ghdh">
					<li>预约时间：</li>
					<input type="date" id="time" name="date"></div>
			</form>
		</div>
		<div class="ghtj">
			<a href="tel:02081656501" class="ghtj1"> <i></i>
				020-81656501
			</a>
			<input class="ghtj2 sub_btn" type="button" value="提交挂号">
		</div>
	</div>
</body>
</html>